The Whole Ball of Wax

Lynn Tilton isn’t happy simply with the prospect of revitalizing MD Helicopters and reclaiming its share of the world’s commercial and military markets and then some. She wants to lock down business—and, logically then, lock out competitors—by offering customers complete solutions to their transportation needs.

She wants to start with emergency medical services.

Most helicopter manufacturers are focused on identifying and satisfying the air-transportation requirements of customers. In the EMS sector, they also address the patient-care requirements of the medical crews in the cabin, through their own capabilities or with completion-center partners.

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By necessity, they leave the matters of how patients are treated on the ground, transported when a helicopter isn’t available or needed and billed for those services to others. They don’t build ambulances, after all, or have large numbers of health-care or medical-billing specialists on their payrolls.

Air medical operators are involved in billing and often are involved in patient-care outside the aircraft. Larger ones run ground-based emergency services, too. But they don’t build helicopters, or ambulances for that matter.

Tilton does all of that, or at least companies do that she owns or has stakes in. She plans to package those capabilities into integrated air, ground and billing proposals in a bid to win more business for all her companies.

“I’d like to be able to do this ourselves,” Tilton said. “This is a business that I would like to ultimately have. I’d like to be able to be the full-source provider. I think over time we’re going to weave together something that’s going to be pretty special to the industry.”

When Tilton’s investment firm, Patriarch Partners, bought controlling interest in MD Helicopters in mid-2005, folks at the Mesa, Ariz. company may have thought they’d only gotten a white knight to save their helicopter lines. But they had become part of a diverse corporate family. Months after she bought MD, Tilton took over American LaFrance. A 175-year-old maker of fire and emergency vehicles (including ambulances), it had become an object of ridicule for poor quality and product support. Tilton vowed to increase the company’s market share and profitability “and become a stronger partner to the fire and EMS community.”

This year, Tilton’s firm bought a controlling stake in Intrepid USA Healthcare Services, which offers a variety of home health-care, assisted-living and rehabilitation services in 26 U.S. states.

Tilton also controls TransCare, which she said is the largest EMS transportation provider in the cities of New York and Baltimore. Its staff includes transportation coordinators, paramedics and emergency medical technicians and handles everything from specially designed shuttle services to the transportation of critically ill neonatal patients. It has a unit that specializes in developing and implementing billing and collections systems. “So we know the health-care industry pretty well,” she said. “One of the nice things is the ability to put a lot of these things together in a lot of different ways.” The addition of MD “has inspired a lot of the mix.”

Tilton said her companies are working to potentially provide regional EMS service through aircraft in New York. “You’d think that in New York, with the major hospitals and the amount of transplant work and emergency work, you’d see a lot more helicopter business coming in from surrounding states,” she said. “That’s something we’re really exploring right now.”

The companies also are working on joint structures with EMS vehicles from American LaFrance for combined aircraft-apparatus-hospital bids to certain municipalities.

“We’re working out of the country on a foreign EMS system that would provide the services of not only EMS aircraft from MD, EMS vehicles from American LaFrance, but our entire dispatch, billing and transport services that we have through TransCare,” she said. “We are pursuing, in one country in the Middle East, perhaps setting up a full-service EMS transport system for much of the Middle East. We’re very much looking into it.”